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Thousands fewer children immunised against common diseases because of lockdown

Lockdown measures in England led to thousands fewer children receiving vital immunisations for a range of diseases include measles, diphtheria and whooping cough, Public Health England (PHE) has warned.

PHE has warned parents they should continue to get their children immunised regardless of lockdown and restrictions brought on by coronavirus.

During the first wave of coronavirus the government advised that children should continue to receive vaccinations as scheduled but despite these some appointments were delayed and the numbers of children vaccinated against common diseases fell compared to 2019.

PHE looked at data from almost 40% of GP surgeries for use of the common 6-in-1 vaccination for diseases including diphtheria, tetanus, whooping cough, and polio as well as uptake of the measles, mumps and rubella (MMR) vaccine to 19 October. 

In total 167,322 children had the 6-in-1 vaccine, a drop of 6,600 on the same period in 2019, a fall of almost 4%. A total of 167,670 children had the MMR jab, 4,700 fewer than in 2019, a drop of 2.8%.  Although the vaccinations recovered after lockdown the rates are still lower overall than 2019.

Dr Mary Ramsay, head of immunisations at Public Health England, said: “Vaccines remain the best defence against infection. It’s essential we maintain the highest possible uptake to prevent a resurgence of serious and sometimes life-threatening diseases.

“Routine vaccinations are still available throughout the pandemic – it’s vital that we continue to make it as easy and safe as possible for parents to take their children to appointments.”

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Source: The Independent, 11 November 2020

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Covid patients ‘head to toe’ on trolleys in A&E spark warnings over ‘lethal’ situation

Patients, including those with the coronavirus, are being kept “head to toe” on trolleys in accident and emergency departments in Manchester, with some forced to wait up to 40 hours for a bed.

The “dangerous” situation has sparked warnings from the president of the Royal College of Emergency Medicine over the “potentially lethal” crowding of patients in A&Es across the country this winter. 

Katherine Henderson said she was “absolutely terrified” by what was happening in some departments. She said she had warned NHS England about the dangers of crowding patients in A&E but that not enough action had been taken.

She told The Independent: “Crowding in A&E is unsafe, but with coronavirus it is potentially lethal. We have said this endlessly to NHS England."

“Everyone agrees crowding is bad, but what they’re not doing is translating that into action.”

After hearing of the situation in Manchester, she added: “Exactly what we said should not happen is happening. I am absolutely terrified by this. What more can I do? I have highlighted this risk everywhere I can over the past few months.”

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Source: The Independent, 11 November 2020

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Cluster of never events has sparked ‘great deal of soul searching’ says trust CEO

An acute trust’s record of eight never events in the last six months has raised concerns that quality standards have slipped since it was taken out of special measures.

The never events occurred at Royal Cornwall Hospitals Trust. They included three wrong site surgeries within the same speciality and an extremely rare incident in which a 30cm (15 inch) wire was left in a cardiology patient.

Kate Shields, chief executive of the trust, said the incidents have led to a “great deal of soul searching”.

Prior to the incidents the trust had gone 13 months without recording a never event, and Ms Shield acknowledged that pressure created by the pandemic was likely to have been a contributing factor behind the cluster of never events.

She stressed that none of the patients affected had suffered physical harm.

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Source: HSJ, 12 November 2020

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Nurse Lucy Letby charged with murder after Chester hospital baby deaths

A nurse is due in court charged with eight counts of murder following an investigation into baby deaths at the Countess of Chester hospital neonatal unit in Cheshire.

Lucy Letby, 30, is due to appear at Warrington magistrates court on Thursday. She was arrested for a third time on Tuesday as part of the investigation into the hospital, which began in 2017.

A force spokesman said: “The Crown Prosecution Service has authorised Cheshire police to charge a healthcare professional with murder in connection with an ongoing investigation into a number of baby deaths at the Countess of Chester hospital.”

He said Letby was facing eight charges of murder and 10 charges of attempted murder relating to the period from June 2015 to June 2016.

On Tuesday, police said parents of all the babies involved were being kept fully updated on developments and were being supported by officers.

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Source: The Guardian, 11 November 2020

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Russian Covid vaccine shows encouraging results

Early results from trials of a Covid vaccine developed in Russia suggest it could be 92% effective.

The data is based on 20 cases of COVID-19 from 16,000 volunteers given the Sputnik V vaccine or a dummy injection.

While some scientists welcomed the news, others said the data had been rushed out too early. It comes after Pfizer and BioNTech said their vaccine could prevent 90% of people getting Covid-19, based on a study of 43,500 people.

Although the Sputnik data is based on fewer people being vaccinated and fewer cases of Covid developing during the trial, it does confirm promising results from earlier research.

The Sputnik V vaccine, developed at the National Research Centre for Epidemiology and Microbiology in Moscow, is currently going through phase III clinical trials in Belarus, UAE, Venezuela and India.

So far there are no safety issues, with Russian researchers saying there were "no unexpected adverse events" 21 days after volunteers received their first of two injections.

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Source: BBC News, 11 November 2020

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Author of gov review forms group to fight ‘woeful’ DHSC response

A Tory peer has attacked the Department of Health and Social Care’s ‘woeful’ response to the patient safety review she authored and has revealed she intends to create a cross-party group to force action.

Baroness Julia Cumberlege - who led the “First Do No Harm” report on device and medicine safety– has said she has “not had a whisper” from the department over the report’s key recommendations since it was published in July.

She told HSJ’s Patient Safety Congress she is setting up a cross-party parliamentary group to “pressure” the department to adopt the report’s recommendations.

The report arose from The Independent Medicines and Medical Devices Safety Review, which spoke to more than 700 people, mostly women, who suffered avoidable harm from surgical mesh implants, pregnancy tests and the anti-epileptic drug sodium valproate.

The report discovered “a culture of dismissive and arrogant attitudes” including the unacceptable labelling of many symptoms as “attributable to ‘women’s problems’”. It concluded that the NHS has “either lost sight of the interests of all those it was set up to serve or does not know how best to do this.”

Health and social care secretary Matt Hancock and minister Nadine Dorries have apologised to the women who were harmed but the department has so far not responded to the report’s other eight recommendations in detail.

Baroness Cumberlege said the cross party group would “[try] to open up a firmly shut departmental door. A department that doesn’t seem to get it.” She said: “We have been disappointed [in the department’s response] because we hoped by now we would have some sort of inclination about what’s going on."

“The response from the department on the other key recommendations has been woeful. The reason they give is ‘there is a terrible amount of work to do’”.

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Source: HSJ, 11 November 2020

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Nurse gaps must be considered in NHS winter planning, warns RCN

Planning around what the NHS can deliver this winter must be based on how many nursing staff are available and the workload they can safely take on, the Royal College of Nursing (RCN) has warned.

Amid widespread nursing shortages, the union has called on the government to “be honest” about nurse vacancies and address what steps need to be taken to keep staff and patients safe.

“It is essential that learning is applied to planning for this winter, including what service can be delivered safely with the workforce available”

Last week NHS England moved to its highest level of emergency preparedness. But the RCN warned it still had grave concerns around how services would be safely staffed, claiming it was too late to find the nurses needed to meet the anticipated demands of the incoming winter.

Despite an increase in the number of nurses registered with the Nursing and Midwifery Council this year, the college said there were still around 40,000 nurse vacancies in the NHS in England alone.

These shortages, which were felt across all areas of nursing, had been exacerbated because of staff self-isolating or being off sick because of COVID-19, the RCN noted.

The impacts of workforce shortages meant there was “enormous responsibility” on the nurses working and “intolerable pressure” on senior nursing leaders, it said. Unless local staffing plans prioritised safe and high-quality care, the few nurses in post were at risk of “burn out” this winter, the college added.

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Source: Nursing Times, 9 November 2020

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Fatigue syndrome exercise therapy loses NICE recommendation

A controversial exercise technique used to manage chronic fatigue syndrome is no longer being recommended by National Institute for Health and Care Excellence (Nice).

The decision to stop recommending graded exercise therapy (GET) – which involves incremental increases in physical activity to gradually build up tolerance – represents a crucial win for patient advocates who have long said the practice causes more harm than good.

Patient groups have argued that the use of exercise therapy suggests that those with chronic fatigue syndrome (also known as ME) have no underlying physical problem but are suffering symptoms due to inactivity.

“We have been so widely dismissed and had our suffering at the hands of this condition constantly diminished by the inappropriate and damaging guidance/notion that we can simply exercise or think our way out of a physical illness none of us asked for nor deserve,” said ME patient Glen Buchanan.

Chronic fatigue syndrome is thought to affect about 250,000 people in the UK and has been estimated to cost the economy billions of pounds annually. One in four are so severely affected they are unable to leave the house and, frequently, even their bed.

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Source: The Guardian, 10 November 2020

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Eating disorders to be tackled with early intervention treatment amid pandemic rise

A new NHS treatment programme targeting young people with eating disorders has been launched amid a rise in numbers needing treatment during the coronavirus pandemic.

Recent NHS data showed record numbers of children and young people are currently being treated across England for eating disorders while waiting times in some places are dangerously long.

On Monday, children’s charity NSPCC warned that counselling sessions for eating and body image disorders rose by 32% after lockdown was introduced in March. The new scaling up of intervention services for those with eating disorders such as anorexia and bulimia will mean young people can gain access to rapid specialist NHS treatment across England.

The service will be rolled out to 18 sites, building on a successful trial model at King's College London, where one patient described the treatment as the “gold standard” of care.

Nadine Dorries, Minister for Health, said: “Eating disorders can have a devastating impact on individuals and their families – and can very sadly be fatal. I am committed to ensuring young people have access to the services and treatment they need which can ultimately save lives."

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Source: The Independent, 10 November 2020

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Coronavirus: Seven in 10 hospital patients suffer from long COVID for weeks after discharge

Study finds 54 days after discharge, 69% of patients still had fatigue, and 53% were suffering from persistent breathlessness.

Almost seven out of 10 patients hospitalised due to coronavirus still suffer from debilitating symptoms more than seven weeks after being discharged, according to a new study.

Researchers from the University College London (UCL) division of medicine, in collaboration with with clinicians at the Royal Free London (RFL) and UCL, followed 384 patients who had tested positive and had been treated at Barnet Hospital, the Royal Free Hospital or UCLH. Collectively the average length of stay in hospital was 6.5 days.

The team found that 54 days after discharge, 69% of patients were still experiencing fatigue, and 53% were suffering from persistent breathlessness. They also found that 34% still had a cough and 15% reported depression. In addition 38% of chest radiographs (X-rays) remained abnormal and 9% were getting worse.

Dr Swapna Mandal, an honorary clinical associate professor at UCL division of medicine, said the data shows so-called long COVID is a real phenomenon and that further research is needed to understand how the symptoms of COVID-19 can be treated over an extended period. She said: "Patients whose COVID-19 illness is serious enough for them to require hospital care often continue to suffer significant symptoms for many weeks after their discharge."

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Source: Sky News, 11 November 2020

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Older women ‘less likely’ to be offered ovarian cancer treatment

Older women could be less likely to receive ovarian cancer treatment.

A new report analysed data from more than 17,000 cases of ovarian cancer diagnosed across England between 2016 and 2018. Three in five (60%) of women with ovarian cancer over the age of 79 did not receive either chemotherapy or surgery, while 37% of women over the age of 70 did not receive any treatment.

The nature of ovarian cancer means surgery is essential in the large majority of cases to remove the tumour.

The researchers cautioned that with an ageing population it is vital that women of all ages have access to the best possible treatments.

Researchers also examined the various rates of treatments for ovarian cancer among women in different parts of England.

They found the probability of receiving any treatment fell below the average in the East Midlands, the East of England, Greater Manchester and Kent and Medway.

The report was jointly funded by The British Gynaecological Cancer Society, Ovarian Cancer Action, Target Ovarian Cancer and delivered by analysts at the National Cancer Registration and Analysis Service.

Commenting on the report, Cary Wakefield, chief executive of Ovarian Cancer Action, said: "Neither your age nor location should decide your chance of survival if you are diagnosed with ovarian cancer."

"Our audit is the first step in addressing the health inequalities women across England face, so we can begin to dismantle them."

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Source: The Independent, 11 November 2020

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Mobile robotic surgeons could treat more patients

Keyhole surgery can allow complicated procedures to be carried out with just a few access cuts, helping to reduce patient recovery times and potential risk of infection.

But the remote controlled robots that can perform this type of surgery are often very large, expensive and not widely available.

Now a new robo-surgeon with a modular design could be about to change that.

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Source: BBC News, 9 November 2020

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Trusts offering controversial trauma ‘treatment’ to new mums

Several NHS trusts are offering a ‘treatment’ for birth trauma which uses a technique which lies outside national guidelines and which is criticised by specialists as potentially causing ‘more harm than good’.

The ‘Rewind’ technique is promoted as a fast treatment for post-natal post-traumatic stress disorder (PTSD) – also known as birth trauma - which involves the “reprocessing” of painful memories.

HSJ has learned of several trusts, including East and North Herts Trust, Chelsea and Westminster Hospital Foundation Trust and James Paget University Hospital FT, where the therapy is being offered. It is thought there are other trusts which are providing it or have explored it. Typically, it is provided by midwives who have undergone training in the technique.

But Nick Grey, a clinical psychologist who was on the National Institute for Health and Care Excellence panel which looked at PTSD, said it was “absolutely clear cut” that it was bad practice to offer the technique as a branded therapy for PTSD, although he said it could be embedded as part of other treatments.

He told HSJ: “It should not be offered to mothers with PTSD… they are being done a disservice if they are not given evidence-based treatment. There is no evidence that this [provides] treatment for sub-clinical PTSD or trauma,” he said.

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Source: HSJ, 11 November 2020

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Mutated coronavirus strain from mink could have 'grave consequences', Matt Hancock warns

The mutated strain of coronavirus from Danish mink could have “grave consequences”, Matt Hancock warned today.

The Health Secretary said the new variant was a “significant development”. And he told MPs the new form of the virus “did not fully respond to Covid-19 antibodies” - hinting it might not respond in the same way to a vaccine.

The UK banned travel and freight from Denmark on Saturday, going further than the current 14-day quarantine system.

Those who had already passed from Denmark to Britain in the previous 14 days must isolate for two weeks.

Updating the House of Commons, Mr Hancock said: “We’ve been monitoring the spread of coronavirus in European mink farms for some time, especially the major countries for mink farming like Denmark, Spain, Poland and the Netherlands.

“On Thursday evening last I was alerted to a significant development in Denmark of a new evidence that the virus had spread back from mink to humans in a variant form that did not fully respond to Covid-19 antibodies.

“Although the chance of this variant becoming widespread is low, the consequences should that happen would be grave.”

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Source: The Mirror, 10 November 2020

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Covid: NHS ready for new vaccine roll-out, says Hancock

The NHS is ready to start providing the new coronavirus vaccine "as fast as safely possible", Health Secretary Matt Hancock has said.

Asked whether it could be available by Christmas, he said that was "absolutely a possibility" - but he expected the mass roll-out "in the first part of next year".

He said vaccination clinics would be open seven days a week, and he was giving GPs an extra £150m.

On Monday, early results from the world's first effective coronavirus vaccine showed it could prevent more than 90% of people from getting Covid. The vaccine has been developed by pharmaceutical companies Pfizer and BioNTech and is one of 11 vaccines that are currently in the final stages of testing.

The UK has already ordered 40 million doses - enough to vaccinate up to 20 million people as each person will need two doses for it to work effectively.

Asked how many people would need to be vaccinated before life can return to normal, Matt Hancock said: "Well the answer to that is we just don't know."

"So the trials can tell you if a vaccine is clinically safe and if it's effective at protecting an individual from the disease. What we can't know, until we've vaccinated a significant proportion of the population, is how much it stops the transmission of the disease."

Mr Hancock told BBC Radio 4's Today programme it would be "a mammoth logistical operation" and highlighted some of the challenges, including getting it from Belgium to the UK while not removing from a temperature of -70C more than four times.

Older care home residents and care home staff are at the top of a list from government scientific advisers of who would get immunised first, followed by health workers. Mr Hancock said NHS staff would go into care homes to vaccinate residents, as well as setting up vaccination venues. Children would not be vaccinated, he said.

However, Prof Sir John Bell from Oxford University said: "I would worry about not giving this to as wide a percentage of the population as we can."

"I'm more of the view that we need to vaccinate further into the population and vaccinate younger people as well, partly because we don't really know what the long term effects of this disease are."

The vaccine will not be released for use until it passes final safety tests and gets the go-ahead from the Medicines and Healthcare products Regulatory Agency.

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Source: BBC News, 10 November 2020

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Covid: NHS staff helped through crisis by 'wobble room'

In small room in the Royal Derby Hospital, there's a table bearing a laminated sign. "You are not alone," it says. It continues: "Kindness will get you through. Embrace the challenge. Look after each other. You are stronger than you think."

This is the "wobble room", set aside not for patients but for front-line staff to get them away - briefly - from the intense pressure and strain experienced in the first wave of COVID-19.

"We made a wobble room because that's what we needed," Kelly-Ann Gurney, an intensive-care nurse, told the BBC. "It's a room where staff could just go and sit and cry if they needed to and get it all out and then come back and 'put their face on' and get back into it again."

Now the second wave is hitting the hospital, and the need for the room is just as great.

Concerns are growing about the physical and mental health of front-line NHS staff. There has been no lull since the April peak of the virus as normal treatments and operations, postponed during the crisis, have returned to hospitals.

Caroline Swan, a senior sister and manager of the intensive care unit at the Royal Derby, says she is ready to face what is ahead but feels very tired. "I am also very concerned. My staff are very tired and stressed out. We have a lot of sickness either due to burnout or they are unwell," she says.

"A lot of staff have to self-isolate at home - and that puts a lot of strain on staffing here."

Dr Magnus Harrison, medical director of the University Hospitals of Derby and Burton NHS Trust, says managing rotas is getting harder due to staff sickness and the need for some to self-isolate if family members are infected.

"It is worth acknowledging what staff did in the first wave. They behaved tremendously and worked incredibly hard, and we're expecting them to do it again in winter - and Covid numbers could be higher than in the first wave. People are tired out."

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Source: BBC News, 10 November 2020

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One in five Covid patients develop mental illness within first three months, study shows

One in five COVId-19 patients were diagnosed with a mental illness for the first time within three months of their infection, a study has shown.

Mental health experts said the findings, which were based on an analysis of the electronic medical records of 69 million people in the US, suggest that coronavirus survivors could have an increased risk of developing psychiatric disorders.

Of the almost 70 million people whose records were examined in the study, 62,354 individuals had confirmed COVID-19 cases.  

Researchers at the University of Oxford and the NIHR Oxford Health Biomedical Research Centre found that one in five of these patients went on to receive a first time diagnosis of anxiety, depression or insomnia within 90 days of testing positive for the virus. This was roughly twice as high as the figure for other individuals over the same time frame, according to the researchers.

People with a history of mental health disorders who contracted the virus were also discovered to be more likely to have new psychiatric diagnoses.

Paul Harrison, a psychiatry professor at the University of Oxford who led the research, said: "People have been worried that COVID-19 survivors will be at greater risk of mental health problems, and our findings in a large and detailed study show this to be likely.

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Source: The Independent, 10 November 2020

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NHS staff to get twice-weekly home covid tests with immediate effect

The NHS will rollout twice-weekly asymptomatic testing for all patient-facing staff by the end of next week, according to a letter from NHS medical director Stephen Powis.

Government said only last week that universal asymptomatic staff testing would start in December, but government has now agreed it will bring this forward to this week for a first tranche of 34 trusts; and all others next week.

The tests at 34 trusts this week will cover “over 250,000 staff,” Professor Powis said. He set out plans for the new testing regime in a letter to Commons health and social care committee chair Jeremy Hunt who has been pressing the government for routine staff testing since the summer.

“Staff will be asked to test themselves at home twice a week with results available before coming into work,” Professor Powis said. The new testing regime can start following “further scientific validation of the lateral flow testing modality last week, and confirmation over the weekend from Test and Trace that they can now supply the NHS with sufficient test kits”.

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Source: HSJ, 9 November 2020

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Pfizer coronavirus vaccine is 90% effective, early data suggest

Pfizer and BioNTech have said that their coronavirus vaccine may be more than 90% effective, after the two pharmaceutical firms released interim data from their ongoing large-scale trial.

Preliminary analysis, conducted by an independent data monitoring board, looked at 94 infections recorded so far in the vaccine’s phase 3 study, which has enrolled nearly 44,000 people in the US and five other countries.

Of those participants who were infected with COVID-19, it is currently unclear how many had received the vaccine versus those who had been given a placebo. The current efficacy rate, which is much better than most experts expected, implies that no more than eight volunteers will have been inoculated.

The data have yet to be peer-reviewed, and Pfizer said the initial protection rate might change by the time the study ends. The longevity of the immune response provoked by the mRNA-based vaccine also remains unknown.

However, the findings are the most promising indication to date that a vaccine will be effective in preventing disease among infected individuals, handing humanity a crucial tool in tackling the pandemic.

Pfizer and its German partner BioTech will continue with the phase 3 trial until 164 infections have been reported among volunteers - a figure that will give regulatory authorities a clearer idea of the vaccine’s efficacy.

This number is expected to be reached by early December in light of the rising US infection rates, Pfizer said.

The two companies said they have so far found no serious safety concerns and expect to seek US emergency use authorisation later this month.

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Source: The Independent, 9 November 2020

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Covid: Cancer delays 'could cause 2,000 deaths in Wales'

As many as 2,000 people could die because of Covid-related delays in the Welsh NHS, a cancer expert has said. With virus cases rising, Prof Tom Crosby, of the Wales Cancer Network, fears cancer cases missed in the first lockdown may now be harder to treat.

Health Secretary Vaughan Gething said it would be "foolish" to have a plan for backlogs before the pandemic is over. But he said work was under way to address the issue with health boards.

Alongside the spread of the virus, medical professionals are very worried about deaths that could occur not because of Covid, but due to the backlog of appointments and surgery it is causing.

BBC Wales Investigates has been uncovering the full extent of the looming problem facing the NHS. 

Delays caused by the pandemic are a serious concern to Prof Crosby, who is medical director at the Wales Cancer Network. He said when the pandemic first hit, acute COVID-19 cases became the focus in hospitals at the expense of cancer, cardiac and orthopaedic appointments.

"Some of the conversations we've had with patients in the clinic have been really, really challenging," he said.

"Then there are thousands of patients who have not come through to the system that usually would have. Some of those are going to have had cancer, and they will not have been diagnosed now."

Prof Crosby has been looking at possible outcomes for cancer patients because of delays in diagnosis and treatment.

"We have done some modelling work with England, and it has suggested that between 200 and 2,000 excess deaths will occur as a result of undiagnosed or untreated cancer in Wales," he said.

"I think the effects on cancer services are going to be here for two to three years."

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Source: BBC News, 9 November 2020

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Covid: Lack of ventilator supplies 'hit' disabled people

Some disabled people in the UK have been struggling to obtain essentials such as medication and breathing equipment during the Covid pandemic, research for the BBC suggests.

Some 60% of those who rely on social care told a YouGov survey they were finding it hard to obtain at least one of their necessities.

Charity WellChild said people felt more "forgotten than they ever have been".

But ministers say the needs of disabled people were being considered. The Department of Health and Social Care says it has sufficient stocks and patients should contact their local care provider.

Like one in 20 of those survey respondents who receive social care, Fi Anderson, a mother of two with muscular dystrophy from Bolton in Greater Manchester, said she has faced problems obtaining breathing apparatus. Her local hospital told her to re-use the filter for her portable ventilator, recommending she boil it, because supplies were so short.

Disabled people who rely on social care - which funds equipment and other support to allow them to live independent lives - also said they had struggled to obtain personal protective equipment (PPE) such as face masks. Many of them receive funding directly to employ carers in their home, so they also need to provide them with PPE during the coronavirus crisis.

The survey, which the BBC commissioned to mark the 25th anniversary of the Disability Discrimination Act, asked more than 1,000 people about life in the UK with a disability and how it has changed in the shadow of a pandemic.

More than 65% felt their rights had regressed, and 71% said disabled people's needs had been overlooked.

The Coronavirus Act, which granted the government emergency powers, gave local councils the ability to reduce care, education and mental health provision for disabled people if it became necessary during the pandemic.

According to the latest figures from the Office for National Statistics, nearly six out of 10 deaths from COVID-19 were of disabled people.

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Source: BBC News, 

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NHS England suspends one-to-one nursing for critically ill Covid patients

Nurses will be allowed to look after two critically ill COVID-19 patients at the same time after NHS bosses relaxed the rule requiring one-to-one treatment in intensive care as hospitals come under intense strain.

NHS England has decided to temporarily suspend the 1:1 rule as the number of people who are in hospital very sick with Covid has soared to 11,514, of whom 986 are on a ventilator.

The move comes amid concern that intensive care units, which went into the pandemic already short of nurses, are being hit by staff being off sick or isolating as a result of Covid. It follows a warning last week by Prof Chris Whitty, England’s chief medical officer, that the Covid resurgence could overwhelm the NHS.

Dr Alison Pittard, the dean of the Faculty of Intensive Care, which represents doctors in ICUs, welcomed the shift to a more “flexible” nurse/patient staffing ratio in critical care. But she said it must be used only for as long as the second wave is putting units under serious pressure.

“Covid has placed the NHS, and critical care in particular, in an unenviable position and we must admit everyone for whom the benefits of critical care outweigh the burdens. This means relaxing the normal staffing ratios to meet this demand in such a way that delivers safe care, but also takes account of the impact this may have on staff health and wellbeing."

“The 1:2 ratio is a maximum ratio, to be used only to support Covid activity, [and] not for planned care, and is not sustainable in the long term. This protects staff and patients”, she said.

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Source: The Guardian, 8 November 2020

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COVID-19: Nursing shortage warning as winter looms

Widespread nursing shortages across the NHS could lead to staff burnout and risk patient safety this winter, the Royal College of Nursing has warned.

The nursing union said a combination of staff absence due to the pandemic, and around 40,000 registered nursing vacancies in England was putting too much strain on the remaining workforce.

The government says more than 13,000 nurses have been recruited this year.

It has committed to 50,000 more nurses by 2025.

It also hopes England's four-week lockdown will ease pressure on the NHS.

The RCN has expressed concern that staff shortages are affecting every area of nursing, from critical care and cancer services to community nursing, which provides care to people in their own homes.

The union said it was worried the extra responsibility and pressure placed on senior nurses could lead to staff "burnout", as hospitals struggle to clear the backlog of cancelled operations from the first wave of coronavirus and cope with rising numbers of new Covid patients, as well as the annual pressures that winter typically brings.

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Source: BBC News, 7 November 2020

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Nontraditional nursing homes in the US have almost no coronavirus cases. Why aren’t they more widespread?

Not a single resident has contracted the coronavirus at Goodwin House’s small residential facility in Northern Virginia, USA, where about 80 seniors live in homey apartments and keep their own sleeping and meal schedules. There’s been just one case at the Woodlands at John Knox Village in Broward County, Fla., where all 140 residents live in private rooms and are cared for by nurses who earn enough not to take a second job.

These facilities, part of a national movement in the US to create less-institutionalised long-term care, stand out in a pandemic that has killed more than 61,000 nursing home residents in the US since March. At “Green House” homes, the best-known nontraditional model, residents are one-fifth as likely to get the coronavirus as those who live in typical nursing homes — and one-twentieth as likely to die of the disease it causes.

The model has been praised by academics and doctors and seems far better suited than traditional facilities to stave off the spread of infection and the isolation that has devastated the elderly in recent months. But it remains on the fringes of a $137 billion industry.

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Source: The Washington Post, 3 November 2020

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Covid: Royal Glamorgan Hospital staff 'broken' by pandemic deaths

An intensive care doctor at one of the hospitals hit hardest by the second wave of coronavirus says staff feel "broken and "exhausted".

Dr Ceri Lynch, consultant anaesthetist at the Royal Glamorgan Hospital in Llantrisant, fears the situation is "worse" than during the first peak in the spring. She spoke of the emotional toil as doctors and nurses watched patients die, and of seeing people's families "decimated" by the virus.

"We are all devastated," she said.

To date, 495 people with coronavirus have died in the Cwm Taf Morgannwg Health Board area - the highest number in Wales.

The hospital serves patients living in some of the hardest hit counties, including Rhondda Cynon Taf which had 553.8 cases per 100,000 of the population in the last week - one of the worst affected communities in the UK.

Dr Lynch said staff at her unit had been left in tears and were "broken" after seeing some of the harrowing effects of the virus, and colleagues had been infected.

Dr Lynch said many relatives were unable to be at their loved-one's bedside when they died, as they were having to self-isolate after contracting the virus themselves. "It's tragic having to do this by telephone or Skype," she said, explaining family members were having to be at their loved-one's death bed via a video call.

"I was crying on Monday, I was at the death of a patient, we try and make the deaths as peaceful as we can, and I think we do a good job. We've had to take the place of the family, hold the patient's hand, talk to them, and communicate with the family, and there's been a lot of tears."

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Source: BBC News, 5 November 2020

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